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Relationship of ankle proprioception measured in weight bearing with balance and walking ability in people with stroke:a cross-sectional study
Get PDFBackground: Proprioceptive deficits are common after stroke. However, limited research has investigated their relationship with functional outcomes (balance and walking ability), particularly in weight-bearing conditions. Objectives: This study aimed to investigate ankle proprioception on both sides (affected and unaffected), measured in biaxial movement directions (plantar flexion and inversion) and relationships with balance and walking ability in stroke survivors. Methods: This cross-sectional study involved 70 mild to moderate, first-time, unilateral stroke survivors. Ankle proprioception was measured in a weight-bearing standing position, using the active movement extent discrimination apparatus (AMEDA). Balance and walking ability were measured using the Berg Balance Scale (BBS), the 10-Meter Walking Test (10MWT) and the Timed Up and Go Test (TUG). Results: Ankle proprioception showed moderate correlations with balance and walking ability (0.4<|r|<0.6, all p < 0.001), regardless of side or movement direction. The only exception was proprioceptive acuity scores for plantar flexion movements made on the unaffected side, which were weakly correlated with BBS (r = 0.3, p = 0.006) and TUG (r = 0.3, p = 0.0015). Regression analysis indicated that ankle proprioception for inversion movement on the affected side was the only factor to independently predict balance (BBS, p = 0.001) and walking ability (10MWT: p < 0.001; TUG: p = 0.01). Ankle proprioception predicts 36% of the variation in BBS, 38% of the variation in 10MWT and 28% of the variation in TUG. Conclusion: Ankle proprioception showed moderate associations with balance and walking ability in people with mild to moderate stroke. These findings suggest that ankle proprioception could potentially be an indicator of post-stroke functional outcomes, warranting further investigation.</p
Potential role of liver-resident CD3<sup>+</sup> macrophages in HBV clearance in a mouse hepatitis B model
Get PDFBackground & Aims: Chronic HBV infection usually causes cirrhosis and hepatocellular carcinoma. Comparative investigations of acute and chronic HBV cases would help determine the immune responses crucial for viral clearance. Methods: A fast-cleared HBV mouse model was established in Alb-Cre mice via hydrodynamic injection of HBV plasmid, while persistent HBV model mice were generated via recombinant covalently closed circular DNA-adeno-associated virus 8 infection. The single-cell transcriptomes of CD45+ intrahepatic non-parenchymal cells from these mice were conducted. Multiplexed immunohistochemistry and flow cytometry were used to confirm the findings from single-cell transcriptomes. Transwell, coculture, and adoptive transfer experiments were performed to study the generation and functions of macrophages. Results: Twenty-four clusters of immune cells were identified. Myeloid cells, including granulocytes, monocytes, and dendritic cells, are activated early in HBV fast-cleared mice. Significantly, a cluster of CD3+ macrophages was found in the viral clearance phase, which was confirmed in liver tissue from five acute patients with HBV. These cells highly expressed CXCL1, tumor necrosis factor alpha, and HBsAg-specific T cell receptors. The transwell assay revealed that CD3+ macrophages originate from macrophages (n = 6). T cells and anti-HBsAg antibodies are indispensable for their differentiation, which was further confirmed in T- and/or B-cell-deficient mice. Interestingly, these CD3+ macrophages capable of killing peptide-loaded hepatocytes and engulfing IgG-coated beads were persistently detectable in the mouse liver for 10 weeks after HBV clearance. The expression levels of CD5L and Bcl2, two classical antiapoptotic proteins, increased (p <0.001), suggesting that the CD3+ macrophages are long-term resident populations. Finally, adoptive transfer of CD3+ macrophages accelerated HBV clearance in mice (n = 5, p <0.01). Conclusions: We identified long-term polyfunctional CD3+ macrophages residing in HBV fast-cleared livers that could help elucidate the immune responses involved in eliminating HBV. Impact and implications: The liver is a special organ with unique immune characteristics and tolerance to foodborne antigens. Chronic infections can develop in newborns after exposure to HBV; however, acute infections usually occur in adults, indicating that immune cells in the liver tissue microenvironment can also effectively fight against the virus. Nevertheless, the mechanisms involved in acute HBV infection have rarely been studied. In this study, we identified a macrophage population with both T cell and macrophage characteristics in the livers of acute HBV model mice and revealed that these macrophages play important roles in HBV clearance. Moreover, we confirmed that this population is derived from macrophages in the presence of virus-specific T cells and antibodies. This finding highlights the complexity of antiviral immune responses in liver microenvironments.</p
Suicidality in Primary Care, Youth Mental Health Services:Prevalence, Risk Factors and Implications for Practice
Get PDFIntroduction: Youth suicide is a concern worldwide, and suicidality—the presence of suicidal ideation or intent—is a critical risk for youth mental health services. This study aimed to determine the prevalence of suicidality in primary care, youth mental health services, along with its correlates and the course of treatment offered to clients. Methods: Routinely collected data from Australia's headspace National Youth Mental Health Foundation, which has over 160 centres across Australia providing mental health care to young people aged 12–25 years, were analysed for new clients who started and completed their first episode of care between 1 July 2022 and 30 June 2023. This included 30 437 young people/episodes of care and 74 393 occasions of service. Results: Results showed that suicidality was evident in almost one-quarter of young people, although it was rarely reported as a primary presenting issue. When present, it was usually identified at first visit. Those most at risk were young people in unstable accommodation, who identified as LGBTIQA+ or who were indigenous. Conclusions: The findings show that suicidality should be anticipated in young people presenting to primary care mental health settings, and youth services need to be able to competently deal with suicide risk rather than using this as exclusion criteria.</p
The Sustainable Personalised Interventions for Cognition, Care, and Engagement (SPICE) Program: Interim analysis of a twelve week multicomponent intervention for people with dementia and care partners
No full textBackgroundThe Sustainable Personalised Interventions for Cognition, Care, and Engagement (SPICE) program was developed to address an identified gap in access to high-quality integrated post-diagnostic rehabilitation for people with dementia and their care partners in Canberra, Australia. The multicomponent intervention aims to maximise quality of life (QoL) and independence of people with dementia by increasing engagement in everyday and meaningful activities and promoting care partners' physical and mental well-being.MethodThe SPICE program is a waiting-list study design delivered by a multidisciplinary allied health team over twelve weeks. The five components are: 1) cognitive stimulation therapy; 2) carer support and capacity building; 3) physical activity; 4) Care of People with dementia in their Environments (COPE) program; and 5) dietary assessment and advice. Each group comprises up to seven people with dementia and their care partners. They engage in group activities twice weekly and receive the COPE program and dietary assessment and advice as a dyad. Outcome measures include QoL, neuropsychiatric symptoms, cognitive and physical function, and carer well-being. Early feasibility of the program contributed to expansion of the study. Here, we report on the first six completed groups.ResultThirty-eight people with dementia and 38 care partners attended group activities with 92% and 91% attendance, respectively. Participants completed 98% of COPE program appointments and 93% of dietary appointments. Pre- to post-program improvements were observed in proxy-reported QoL (p = 0.02), reduced neuropsychiatric symptoms (p<0.001) and carer distress related to these symptoms (p = 0.04), and reduced caregiving challenges (p<0.001). Both people with dementia and care partners improved in the Alternating Step Test (AST) (both; p<0.001), as did care partners in Timed Up and Go (TUG) (p = 0.04). Twenty-six people with dementia and 26 care partners have completed follow-up, improving from baseline to 24 weeks in self-reported QoL of the person with dementia (p = 0.03), and reduced neuropsychiatric symptoms (p<0.01) and carer distress related to these symptoms (p = 0.02). Care partners maintained improvements in the AST (p<0.01) and TUG (p = 0.05).ConclusionInterim analysis suggests the SPICE program benefits people with dementia and their care partners. Further results are required to support continuation and expansion of the program
Putting the Fe into female athletes: Insights into heightened iron status and women’s Australian Football performance:A case study.
No full textBackground: Iron deficiency affects up to 70% of female athletes, yet the effectiveness of improving iron status in team sport athletes remains unclear. Purpose: To evaluate the impact of variations in iron status on physical performance in elite female Australian Rules Football players. Methods: Iron status was measured in 30 players (age 23 ± 4 y; body mass 70 ± 6 kg) across three time-points of a 24-week season. Players identified as iron deficient non-anemic stage 2 in week 1 received an iron infusion. Remaining players were categorized into heightened iron status (FeUP; iron deficient non-anemic stage 1 players who were advised to take iron supplementation; n = 8) or non-supplemented (Ctrl; week 10: n = 17; week 24: n = 16) groups following week 10. Relative external load measures (e.g., total distance at different velocities), and strength and power measures (e.g., counter-movement jump, reactive strength index) were recorded in weeks 10 and 24 (same weeks as blood samples) to compare physical performance between FeUP and Ctrl groups. Results: Iron status improved in FeUP (30 µg/L to 49 µg/L) and reduced in Ctrl (39 µg/L to 34 µg/L) between weeks 10 and 24. Iron deficiency prevalence among all players was 47–54%. FeUp exhibited small to moderate improvements (5–19%) in some external load measures but no consistent improvement across all measures. At week 24, FeUP showed trivial to moderate differences outperforming Ctrl in seven physical performance measures (e.g., both hip adduction tests), but Ctrl outperformed FeUP in all other measures. Conclusion: Heightened iron status does not consistently enhance physical performance, although avoiding deficiency remains essential for athlete health
Does walking for transport contribute to the longitudinal association between neighbourhood walkability and body mass index among mid-to older-aged Australian adults?
No full textIntroduction: Studies examining the associations between neighbourhood walkability and adult body weight, as well as the potential mediating role of walking for transport (WfT), are mainly cross-sectional, and longitudinal evidence is lacking. This study investigated the longitudinal association between walkability and body mass index (BMI) and assessed the contribution of WfT to this association. Methods: Data from the HABITAT multilevel longitudinal (2007–16) study of 11,035 middle-aged adult residents of 200 neighbourhoods in Brisbane, Australia, were used. Neighbourhood walkability within a 1 km network buffer around residents’ homes was objectively measured using land use mix, street connectivity, and residential density, and BMI was measured using self-reported height and weight. At each wave (2007, 2009, 2011, 2013 and 2016), respondents estimated the duration (minutes) of WfT in the previous 7 days, which was modelled as both a binary and continuous measure. Mixed-effects regression models were used to examine whether any WfT (yes/no) contributed to the association between walkability and BMI, and generalised structural equation modelling was used to estimate the mediating effect of minutes WfT on this relationship. The models were adjusted for age, sex, education, occupation, household income, neighbourhood disadvantage, survey year, and residential self-selection. Results: Living in a walkable neighbourhood was significantly associated with greater odds of engaging in any WfT and more minutes of walking, and each measure of walking was associated with a lower BMI. Any WfT made no apparent contribution to the association between walkability and BMI, whereas minutes spent walking explained approximately 7.8 % of this relationship. Conclusions: Walkable neighbourhoods may help reduce BMI at the population and individual levels by promoting WfT. Creating walkable communities to support WfT holds the potential for maintaining a healthy body weight and preventing the onset of weight-related chronic conditions such as diabetes and cardiovascular disease.</p
Development of Australian mental health guidelines for community sport
Get PDFObjective: The need for clear and actionable guidelines for the promotion and protection of mental health in organised community sport has previously been identified. This study aimed to provide guidelines to promote and protect mental health in organised community sport in Australia. Methods: Guideline development was informed by (1) systematic reviews of the evidence pertaining to existing mental health guidelines in sport and mental health interventions in community sport; (2) an expert Delphi consensus study and (3) key stakeholder input via focus groups. A Guideline Development Committee comprising experts and key stakeholder representatives articulated nine distinct guidelines. Results: These guidelines address the areas of: mental health literacy training; mental health support pathways and processes; responding to mental health emergencies; responding to major events that may impact mental health; having a mental health plan in place; reducing stigmatising attitudes; appointing a dedicated mental health champion; coach education and promoting well-being within the organisation. Conclusions: We provide guidance for promoting and protecting mental health in community sport. Monitoring uptake and measuring the effectiveness of the guidelines are important areas of future work to advance positive mental health for everybody involved in community sport.</p
Corruption, sustainable development goals performance and modern slavery practices:an international evidence
Get PDFPurpose: This study examines the two key research question; (1) Does country-level corruption give rise to modern slavery (MS) practices and (2) Does sustainable development goals (SDGs) performance of different jurisdictions reduce MS practices? Design/methodology/approach: Using a sample of 431 country-year observations (for the period of 2016, 2018 and 2023) from 146 countries, the study test hypotheses applying different econometrics analysis and conducts robustness tests. Findings: Our results indicate that country-level corruption practices increase MS practices in different contexts. These results hold when we use alternative measures for MS construct. Our study also reported that MS practices in different jurisdictions are lessened when country-level SDGs performance is higher. Our additional analysis finds that higher country-level debt serves as a channel between corruption and MS practices. Research limitations/implications: Practically, the findings of the study have a take-away message for different global actors, in particular, different countries’ governments, national regulators working to abate corruption and slavery issues. For other actors such as the United Nations, the ILO and others, the findings will have practical value for their new policy development and interventions. Originality/value: To the best of our knowledge, this study is the first that investigated the role of country-level corruption on MS practice at the country level. Similarly, our attempt towards exploring the impact of country-level sustainable development goals (SDGs) performance on the MS practices is also primary in the literature. Lastly, developing a single framework by integrating different countries’ MS practices with corruption and SDGs performance and providing related empirical evidence with global level data is a new initiative in the accounting and sustainability literature.</p
Practical Applications of Research Outcomes—Who, How, and When
No full textResearch information moves very quickly in this age of social media and online platforms. The scholarly practice of not releasing or publicizing research outcomes (and their importance and application) until after formal peer-reviewed journal publication has largely disappeared. Researchers are keen to promote their work, and a key aspect of the likely impact is prominent reporting of the study’s practical applications.<br/
Coproducing futures: A three-mode heuristic for reflexive practice toward sustainability
No full textCoproduction is commonly used as an action-oriented practice to collaborativelyproduce knowledge for different purposes, including supporting institutionalchange to navigate uncertainty and complexity while enabling pathways to sus-tainable futures. Futures thinking and related tools are also used to conceive newpossibilities or alternative futures and increase collective understanding of changeprocesses. Yet, despite common themes of change, uncertainty, and transforma-tion being strongly related to how we envision and imagine the future, there hasbeen relatively little cross-fertilization between coproduction and futures thinking,specifically, to understand how the explicit use of the latter can facilitate sustain-ability transformations. A fundamental question remains about how to facilitatereflexivity and critical thinking across multiple actors, knowledge systems, andvalues, to shape coherent imaginaries of just and sustainable futures. This articleexplores the potential of a heuristic relating three modes of futures thinking (pre-dictive, anticipatory, and speculative) and their interconnections to strengthenreflexive and future-oriented practices in coproduction. We document insights from coproduction researchers and practitioners applying these three modes offutures thinking in their work and how these support reflexive practices. We dis-cuss gaps and opportunities for more future-oriented coproduction that increasecollective awareness and responsible stewardship of nature. Our heuristic canenable critical thinking from researchers and practitioners involved in the pursuitof sustainability transformations to better integrate science, policy, and commu-nity engagement to identify innovative ways to address power imbalances and amore proactive engagement with the future